Cardiac – Logistics

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Who's Who?
  • Rotation Education Director: Agnes Lesicka, M.D.
  • Fellowship Director: Mike Andrawes, M.D.
  • Division Lead: Mike Fitzsimons, M.D.
Rotation Goals
  • The goal of the first month of the rotation is to gain familiarity with cardiopulmonary bypass cases and cardiac diseases that you will face throughout your career as an anesthesiologist. As such, the early part of your rotation will focus on “routine” cardiac surgical cases, such as CABG, AVR and MVR. These cases will allow you to focus on the flow of a routine cardiac anesthetic, management of induction, invasive line placement and pressor selection/management. You will be introduced to cardiopulmonary bypass management and learn the basics of TEE.

  • The goal of the second month of the rotation is to deepen your understanding of cardiac anesthesia. You should be ready to take on more complex cases such as DHCA, redo operations, pulmonary thromboendarterectomy, mechanical circulatory support as well as non-CPB cases such as TAVR, MitraClip, etc.

Professional Expectations - MUST READ
  1. Make certain that all in-house pre-operative evaluations are complete – including those for the post-call resident.
  2. All residents are expected to call the attending physician the day prior to a case unless a discussion occurs during the day or you have already called a fellow that you are co-assigned with.
  3. All residents are expected to perform a post-operative evaluation on any patient undergoing cardiac surgery within 48 hours of the completion of surgery. The weekend call resident is expected to complete the post-operative evaluations on patients whose procedure occurred on Friday.
  4. All residents are expected to arrive with enough time to set up their room for the day. Typically around 5:45-6:00 AM.
  5. The on-call resident must set up the cardiac ORs for the following day, including emergency drugs. On weekends, the cardiac crunch room should always be set up.
  6. The residents are expected to attend DACCPM Grand Rounds and Case Conference on Thursday mornings. If you get paged regarding your case, please redirect them to your attending.
  7. Residents are expected to notify their staff, director of resident education or division chief if they are in danger of violating the ACGME duty hours. If a given clinical day runs late, residents are to be off for 10 hours between shifts, and must notify their staff.
  8. The Resident on-call will hand off the cardiac service pager to the Attending on call in the morning at 7am (even on Thursdays).(On Thursday mornings, page the on-call attending to arrange the pager hand-off).The pager is not to be passed on to other residents, fellows or left unattended. The on-call resident will pick up the pager from the on-call attending in the evenings.
  9. Residents are expected to check out with the on-call attending prior to leaving for the day or after call.
  10. Residents are expected to become familiar with and comply with the cardiac anesthesia quality measures – which currently emphasize documenting beta-blockade administration.
Case/Room Assignments
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  • If you would like to spend time in the Cardiac Surgical ICU, or other offsite locations, let Agnes know. We can certainly work to make it happen.

Room Setup
  • Cardiac case setup differs in meaningful ways from other case types. Please review this linked PDF for helpful information on set-up.
  • Lectures are ad hoc, depending on clinical volumes. Most staff have prepared materials, so if there is a lull, make sure to hit them up.
  • The CAGEDU drive contains articles, TEE videos and other reference material.

ACGME & Program Requirements
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  • The CAGEDU drive contains articles, TEE videos and other reference material.